Institute for Health Promotion, Graduate School of Public Health, Yonsei University College of Medicine, Seoul, South Korea.
Am J Epidemiol. 2009 Dec 15;170(12):1478-85. doi: 10.1093/aje/kwp308. Epub 2009 Nov 16.
The authors explored the association of cigarette smoking with tuberculosis incidence, recurrence, and mortality. A 14-year prospective cohort study (1992-2006) was carried out in 1,294,504 South Koreans. Participants were grouped by smoking history, and the authors assessed tuberculosis incidence, mortality, and recurrence risk for each group. Unadjusted and adjusted Cox proportional hazards models were used to investigate the association between smoking history and the 3 outcomes of interest, adjusting for age and alcohol use. Compared with never smokers, current smokers had increased mortality from tuberculosis among both men (adjusted hazard ratio (HR) = 1.6, 95% confidence interval (CI): 1.3, 2.0) and women (HR = 1.6, 95% CI: 1.0, 2.4). Current male smokers had greater risk of incident tuberculosis than former smokers (HR = 1.4, 95% CI: 1.3, 1.5), and risk among current smokers increased with number of cigarettes smoked daily. In females, cigarette smoking was not associated with incident tuberculosis. There was interaction between smoking and sex for incidence (P = 0.00047). The effect of smoking was generally reduced with adjustment for body mass index. Among men, the highest alcohol consumption category (> or =100 g/day) was associated with risk of incident tuberculosis (HR = 1.5, 95% CI: 1.3, 1.7). This study provides longitudinal evidence that smoking increases risk of incident tuberculosis, mortality from tuberculosis, and tuberculosis recurrence.
作者探讨了吸烟与结核病发病率、复发和死亡率之间的关联。这项为期 14 年的前瞻性队列研究（1992-2006 年）在 1294504 名韩国人中进行。参与者根据吸烟史进行分组，作者评估了每组的结核病发病率、死亡率和复发风险。使用未经调整和调整后的 Cox 比例风险模型来研究吸烟史与 3 个感兴趣结局之间的关联，调整了年龄和饮酒因素。与从不吸烟者相比，男性（调整后的危险比（HR）=1.6，95%置信区间（CI）：1.3，2.0）和女性（HR=1.6，95%CI：1.0，2.4）中的现吸烟者结核病死亡率增加。与女性相比，男性现吸烟者的结核病发病风险更高（HR=1.4，95%CI：1.3，1.5），而且随着每日吸烟量的增加，风险也随之增加。在女性中，吸烟与结核病发病无关。吸烟和性别之间存在交互作用（P=0.00047）。调整体重指数后，吸烟的影响通常会降低。在男性中，最高饮酒类别（>或=100 克/天）与结核病发病风险相关（HR=1.5，95%CI：1.3，1.7）。这项研究提供了纵向证据，表明吸烟会增加结核病发病、结核病死亡率和结核病复发的风险。
